Fort Wayne Orthopaedics, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

FORT WAYNE ORTHOPAEDICS, LLC

Practice address

701 Orthopedic Dr.
Warsaw, IN 46582-3905

Phone

(260) 436-8686

Fax

(260) 436-8585

NPI assigned

Jan 5, 2016

Last updated

Sep 14, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jerald L. Cooper, MDNPI 1598768566

Title

President

Phone

(260) 436-8686

Specialties & licenses 1

Addresses

Other names 1

• Fort Wayne Orthopedics, LLC Other name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Fort Wayne Orthopaedics LLC

  • Orthopaedic Surgery Physician
  • Fort Wayne, IN
  • NPI 1497758429

  7618965286

  Same PAC ID
• Fort Wayne Orthopaedics, LLC

  dba Fort Wayne Orthopedics, LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1033320510

  7618965286

  Same PAC ID

Tax ID family

Fort Wayne Orthopedics LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fort Wayne Orthopaedics, LLC

  dba Fort Wayne Orthopedics, LLC

  • Durable Medical Equipment & Medical Supplies
  • Fort Wayne, IN
  • NPI 1033320510
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerald L Cooper, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Fort Wayne, IN
  • NPI 1598768566
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1982060190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2526",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468012526",
            "telephone_number": "260-436-8686",
            "fax_number": "260-436-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 ORTHOPEDIC DR.",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465823905",
            "telephone_number": "260-436-8686",
            "fax_number": "260-436-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE ORTHOPAEDICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "JERALD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-436-8686",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Wayne Orthopedics, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Fort Wayne Orthopedics, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Megan Flager, PA-C
• Adria Lynn Ford, D.O.
• Jordan Foreman
• Angela Foresman, MSW, LCSW
• Fort Wayne Orthopaedics, LLC
• Forte Home Health Care, Inc
• Forte Residential, Inc
• Chloe Lindemann Francis, PHARMD
• Jarod Franklin, DC
• Nikkiya M. Fraser, MD

• Durable Medical Equipment & Medical Supplies in Warsaw, IN
• Providers in Warsaw, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.